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Phase 2A revision > cardio to work on COPY > Flashcards

cardio to work on COPY Flashcards

1
Q

Name 3 differential diagnoses for angina

A
  1. Pericarditis/myocarditis
  2. PE
  3. Chest infection
  4. Dissection of aorta
  5. GORD
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2
Q

Name 3 possible differential diagnoses of MI

A
  1. Pericarditis
  2. Stable angina
  3. Aortic dissection
  4. GORD
  5. Pneumothorax
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3
Q

what are the clinical features of PE?

A

SYMPTOMS

  1. Breathlessness
  2. Pleuritic chest pain
  3. signs/symptoms of DVT

SIGNS

  1. Tachycardia
  2. Tachypnoea
  3. pleural rub
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4
Q

Name 3 differential diagnoses for acute pericarditis

A
  1. MI
  2. Angina
  3. Pneumonia
  4. Pleurisy
  5. PE
  6. GORD
  7. pneumothorax
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5
Q

what are the treatments for peripheral vascular disease?

A 
Control risk factors:
    - Smoking cessation
    - Regular exercise
    - Weight reduction
    - BP control, DM control
    - Statin 
Antiplatelet therapy:
    - Aspirin/clopidogrel
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6
Q

what are the clinical signs of left heart failure?

A
  1. Pulmonary crackles
  2. S3 and S4 and murmurs
  3. Displaced apex beat
  4. Tachycardia
  5. fatigue
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7
Q

what are the clinical features of right HF?

A
  1. Raised JVP
  2. Ascites
  3. peripheral oedema
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8
Q

what is the management for chronic HF?

A

1st line = ACEi, beta blocker
2nd = ARB + nitrate
3rd = cardiac resynchronization or digoxin
4th = diuretics (furosemide)
5th = aldosterone antagonist (spironolactone)

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9
Q

what are the side effects of ACE inhibitors?

A
  1. Hypotension
  2. Hyperkalaemia
  3. Acute renal failure
  4. Teratogenic
  5. cough - from build up of kinin
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10
Q

Give 4 potential side effect of ARBs

A
  1. Hypotension
  2. Hyperkalaemia
  3. Renal dysfunction
  4. Rash
    Contraindicated in pregnancy
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11
Q

Give 3 potential side effects that are due to the vasodilatory ability of CCBs

A
  1. Flushing
  2. Headache
  3. Oedema
  4. Palpitations
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12
Q

Give 2 potential side effects that are due to the negatively chronotropic ability of CCBs

A
  1. Bradycardia
  2. Atrioventricular block
  3. Postural hypotension
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13
Q

Give a potential side effect that is due to the negatively inotropic ability of CCBs

A

Worsening cardiac failure

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14
Q

Give 5 potential side effects of diuretics

A
  1. Hypovolaemia
  2. Hypotension
  3. Reduced serum Na+, K+, Mg+, Ca2+
  4. Increased uric acid –> gout
  5. Erectile dysfunciton
  6. Impaired glucose tolerance
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15
Q

What are the functions of ANP and BNP?

A
  1. Increased renal excretion of Na+ and water
  2. Vasodilators
  3. Inhibit aldosterone release
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16
Q

How does digoxin work?

A

Inhibits the Na+/K+ pump therefore making the action potential more positive and ACh is released from parasympathetic nerves

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17
Q

What are the main effect of digoxin?

A
  1. Bradycardia
  2. Reduced atrioventricular conduction
  3. Increased force of contraction (positive inotrope)
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18
Q

Give 3 potential side effects of digoxin

A
  1. Nausea
  2. Vomiting
  3. Diarrhoea
  4. Confusion
    Also has a narrow therapeutic range
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19
Q

Name 4 potential effects of amiodarone

A
  1. QT prolongation
  2. Interstitial lung disease
  3. Hypothyroidism
  4. Abnormal liver enzymes
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20
Q

Name a disease that might cause tall P waves

A

Right atrial enlargement

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21
Q

Name a disease that might cause broad notched P waves

A

Left atrial enlargement

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22
Q

Give 2 effects of hypokalaemia on an ECG

A
  1. Flat T waves
  2. QT prolongation
  3. ST depression
  4. Prominent U waves
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23
Q

Give an effect go hypocalcaemia on an ECG

A
  1. QT prolongation
  2. T wave flattening
  3. Narrowed QRS
  4. Prominent U waves
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24
Q

Give an effect of hypercalcaemia on an ECG

A
  1. QT shortening
  2. Tall T wave
  3. No P waves
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25
Q

Give 3 potential consequences of arrhythmia

A
  1. Sudden death
  2. Syncope
  3. Heart failure
  4. Chest pain
  5. Palpitations
    May also be asymptomatic
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26
Q

Give 2 causes of bradycardia

A
  1. Conduction tissue fibrosis
  2. Ischaemia
  3. Inflammation/infiltrative disease
  4. Drugs
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27
Q

what is the clinical presentation of AV node re-entry tachycardia (AVNRT)?

A

Rapid regular palpitations – abrupt onset, sudden termination
Chest pain and breathlessness
Neck pulsations
Polyuria

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28
Q

Describe the acute treatment of AV node re-entry tachycardia (AVNRT)

A

Vagal manoeuvre,
carotid sinus massage
catheter ablation and adenosine (block AVN to terminate the SVT)

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29
Q

Describe 3 characteristics of an ECG from someone with accessory pathway arrhythmia

A
  1. Delta wave
  2. Short PR interval
  3. Slurred QRS complex
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30
Q

Give 4 causes of sinus tachycardia

A
  1. Physiological response to exercise
  2. Fever
  3. Anaemia
  4. Heart failure
  5. Hypovolaemia
  6. pain
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31
Q

What is the treatment for stable ventricular tachycardia?

A

IV beta blockers (bisoprolol) and IV amiodarone

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32
Q

what is the clinical presentation of atrial fibrillation?

A

can be asymptomatic

  1. SOB
  2. Chest pain
  3. Palpitations
  4. Syncope
  5. fatigue
  6. apical pulse greater than radial pulse
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33
Q

what are the causes of atrial fibrillation?

A 
Idiopathic 
Hypertension 
Heart failure 
Coronary artery disease 
Valvular heart disease 
Cardiac surgery 
Cardiomyopathy
Rheumatic heart disease
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34
Q

What does the CHA2DS2 VASc score take into account

A 
CHD
HTN
Age (>75) = 2 points
DM
Stroke (previous) = 2 points
Vascular disease
Age 65-74 
Sex (female)

Score >1 = anticoagulation

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35
Q

Describe the treatment for atrial fibrillation

A
  • cardioversion - LMWH (enoxaparin) and DC shock
  • rate control - 1st line = beta blocker, 2nd line = CCB
  • rhythm control - BB (bisoprolol), CCB (verapamil), digoxin, anti-arrhythmic (amiodarone)
  • anti-coagulation
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36
Q

What might you give someone to help restore sinus rhythm in atrial fibrillation?

A

Electrical cardioversion or pharmacological cardioversion using flecainide

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37
Q

What is atrial flutter?

A

Fast but organised waves in the atrium

Atrial rate 250-350 bpm

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38
Q

Describe the pathophysiology of atrial flutter

A

the P wave produces a sawtooth pattern with regular conduction to the ventricles
- Wave of contraction around the atria causing the repolarisation of the AV node

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39
Q

what are the causes of long QT syndrome?

A
  1. Congenital
  2. hypokalaemia,
  3. hypocalcaemia
  4. Drugs - amiodarone, tricyclic antidepressants
  5. bradycardia
  6. Acute MI
  7. diabetes
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40
Q

what are the causes of heart block?

A 
Athletes
Sick sinus syndrome
IHD – esp MI
Acute myocarditis
Drugs
Congenital 
Aortic valve calcification
Cardiac surgery/trauma
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41
Q

what are the symptoms of aortic stenosis?

A

Occur when valve area is 1/4 of normal (normal - 3-4 cm2)

  1. Exertional syncope
  2. Angina
  3. Exertional dyspnoea
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42
Q

what are the signs of aortic stenosis?

A
  • ejection systolic murmur radiating to carotids and apex - crescendo-decrescendo
  • sustained, heaving apex
  • slow rising pulse
  • narrow pulse pressure
  • soft S2 if severe
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43
Q

what are the symptoms of mitral regurgitation?

A

palpitations
exertional dyspnoea
fatigue
weakness

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44
Q

Give 3 signs of mitral regurgitation

A
  1. Pan-systolic murmur radiating to left axilla
  2. Soft/absent S1
  3. displaced, thrusting apex
  4. atrial fibrillation
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45
Q

What is the management of mitral regurgitation?

A
  • Mild is managed by following patient with echoes every 1-5yrs
  • Beta-blockers - ATENOLOL
  • Calcium channel blockers
  • DIGOXIN
  • Diuretics - FUROSEMIDE
  • ACEIs - RAMIPRIL or HYDRALAZINE
  • Surgical intervention if severe and symptomatic or
    - If ejection fraction <60%
    - New onset AF
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46
Q

What causes aortic regurgitation?

A

acute

  • infective endocarditis
  • rheumatic fever
  • aortic dissection

chronic

  • rheumatic disease
  • bicuspid aortic valve
  • aortic endocarditis
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47
Q

Give 3 symptoms of aortic regurgitation

A
  • palpitations
  • angina
  • dyspnoea
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48
Q

Give 3 signs of aortic regurgitation

A
  • early diastolic murmur - decrescendo
  • water hammer (collapsing) pulse
  • wide pulse pressure
  • displaced apex
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49
Q

What investigations might you do in someone who you suspect to have aortic regurgitation?

A

CXR - cardiomegaly, aortic root enlargement
ECHO - assess severity
ECG - left ventricular hypertrophy
cardiac catheterisation

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50
Q

What investigation might you do in someone who you suspect to have aortic stenosis?

A
  • Echocardiography
  • CXR - cardiomegaly, dilated ascending aorta, pulmonary oedema, LV enlargement
  • ECG - depressed ST and T wave inversion
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51
Q

What investigations might you do in someone who you suspect to have mitral regurgitation?

A
  1. ECG
  2. CXR
  3. Echo - estimates LA/LV size and function
  4. doppler and colour flow doppler to measure severity
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52
Q

Describe the management for someone with aortic regurgitation

A

IE prophylaxis
ACEi (ramipril) = vasodilators
Regular echos - motion progression
Surgery if symptomatic

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53
Q

what are the symptoms of mitral stenosis?

A
  1. progressive dyspnoea
  2. Haemoptysis (coughing up blood)
  3. palpitations (AF)
  4. chest pain
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54
Q

what are the signs of mitral stenosis?

A

rumbling mid-diastolic murmur with opening snap - decrescendo-presystolic crescendo

  1. malar flush
  2. AF
  3. tapping apex beat
  4. low volume pulse
  5. loud snapping S1
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55
Q

What investigations might you do in someone who you suspect to have mitral stenosis?

A
  1. ECG - AF, left atrial hypertrophy causes bifid P wave
  2. CXR - large L atrium, pulmonary oedema
  3. Echo - gold standard for diagnosis
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56
Q

Describe the management for mitral stenosis

A

If mild treatment is not required
Beta blockers control HR - ATENOLOL and DIGOXIN
Diuretics for fluid overload - FUROSEMIDE
Percutaneous balloon valvotomy to increase size of mitral valve opening
Mitral valve replacement

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57
Q

what are the risk factors for infective endocarditis?

A
  • IV drug use
  • poor dental hygiene
  • skin and soft tissue infections
  • dental treatment
  • IV cannula
  • cardiac surgery
  • pacemaker
  • immunocompromised
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58
Q

What investigations might you do in someone who you suspect to have infective endocarditis?

A
  1. Blood cultures - essential
  2. Echo - TTE ot TOE
  3. Bloods - raised ESR and CRP, normochromic normocytic anaemia
  4. ECG - long PR interval, MI
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59
Q

Describe the treatment for infective endocarditis

A
  1. Antibiotics based on cultures
  2. Treat any complications
  3. Surgery - remove and replace valve
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60
Q

What additional property makes propranolol the most useful beta blocker to help control the arrhythmias which occur immediately following a heart attack?

A

It can also block sodium channels

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61
Q

What are the 4 main features of tetralogy of fallot?

A
  1. Ventricular septal defect
  2. Over-riding aorta
  3. RV hypertrophy
  4. Pulmonary stenosis
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62
Q

What are the risks associated with Eisenmengers syndrome?

A
  1. Risk of death
  2. Endocarditis
  3. Stroke
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63
Q

How does mild coarctation of the aorta present?

A

Presents with hypertension
Incidental murmur
Should be repaired to try to prevent problems in the long term

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64
Q

What long term problems can occur due to coarctation of the aorta?

A

Hypertension - early CAD, early stroke, subarachnoid haemorrhage
Re-coarctation requiring repeat intervention
Aneurysm formation at the site of repair

65
Q

How does a patient present with pulmonary stenosis?

A 
Right ventricular failure 
Collapse 
Poor pulmonary blood flow 
right ventricular hypertrophy
Tricuspid regurgitation
66
Q

What are 3 problems with a bicuspid aortic valve?

A
  1. Degenerate quicker than normal valves
  2. Become regurgitant earlier than normal valves
  3. Associated with coarctation and dilation of ascending aorta
67
Q

What is Dressler’s syndrome?

A

Myocardial injury stimulates formation of autoantibodies against the heart
Cardiac tamponade may occur
Dressler’s is a secondary form of pericarditis

68
Q

Give 3 symptoms of Dressler’s syndrome

A
  1. Fever
  2. Chest pain
  3. Pericardial rub
    Occurs 2-10 weeks after MI
69
Q

Write an equation for mAP

A

mAP = DP + 1/3PP

70
Q

Give the equation for stroke volume

A

SV = EDV - ESV

71
Q

Give 2 diseases that result from stress induced ischaemia

A
  1. Exercise induced angina

2. Intermittent claudication

72
Q

Give 2 disease that result from ischaemia due to structural/functional breakdown

A
  1. Critical limb ischaemia

2. Vascular dementia

73
Q

Name 2 diseases that are due to moderate ischaemia

A
  1. Angina

2. Intermittent claudication

74
Q

Name 3 causes of an aneurysm

A
  1. Atherosclerotic (most common)
  2. Ateriomegaly
  3. Collagen disease - Marfans, vascular Ehlers Danlos
  4. tobacco smoking
75
Q

Describe the pathophysiology of an aortic dissection

A

Tear in intimal lining of aorta –> column of blood under pressure enters aortic wall forming haematoma –> separates intima from adventitia –> false lumen
False lumen extends –> intimal tears

76
Q

what is the management for an NSTEMI?

A
  • use grace score to predict 6 month mortality and risk of further cardiac events
  • antiplatelet therapy = aspirin + clopidogrel

antithrombin = LMWH

BB + nitrate

statins

77
Q

what is the role of preload in heart failure?

A
  • heart failure causes decreased volume of blood ejected with each heart beat
  • the myocardial fibres stretch and don’t contract as much
78
Q

what is the role of afterload in heart failure?

A
  • increased afterload causes increased EDV
  • this causes decreased SV and decreased CO
  • this is a vicious circle and continues to exacerbates the problem
79
Q

what are the causes of cor pulmonale?

A
  • chronic lung disease
  • pulmonary vascular disorders
  • neuromuscular and skeletal diseases
80
Q

what are the signs of cor pulmonale?

A
  • cyanosis
  • tachycardia
  • raised JVP
  • RV heave
  • pan-systolic murmur due to tricuspid regurgitation
  • hepatomegaly
  • oedema
81
Q

what investigations should be undertaken for cor pulmonale?

A

arterial blood gas

  • hypoxia
  • sometimes shows hypercapnia
82
Q

what is the management for cor pulmonale?

A
  • treat the underlying cause
  • oxygen
  • diuretics
  • venesection if haematocrit >55
  • heart-lung transplant in young patients
83
Q

what are the causes of atrial flutter?

A
  • idiopathic
  • CHD
  • hypertension
  • heart failure
  • COPD
  • pericarditis
  • obesity
84
Q

what is the management for atrial flutter?

A
  • Cardioversion
    - Give a LMWH
    - Shock with defibrillator
  • Catheter ablation = definitive treatment – creates a conduction block
  • IV Amiodarone – restore sinus rhythm
85
Q

what are the risk factors for AVNRT?

A 
exertion
emotional stress
coffee
tea
alcohol
86
Q

what are the consequences of malignant hypertension?

A
  • cardiac failure (LVH)
  • blurred vision (papilledema)
  • haematuria - due to fibrinoid necrosis of glomeruli
  • severe headache and cerebral haemorrhage
87
Q

what is the treatment for recurrent pericarditis?

A
  • The first line treatment is oral NSAIDs e.g. Ibuprofen
  • Colchicine has been proven to be more effective than Aspirin alone
  • In resistant cases, oral corticosteroids e.g. -Prednisolone may be effective, and in some patients, pericardiectomy (removal of part/most of the pericardium) may be appropriate
88
Q

what is the clinical presentation of pericardial effusion?

A
  • Symptoms of a pericardial effusion commonly reflect the underlying pericarditis
  • Soft & distant heart sounds
  • Apex beat obscured
  • Raised jugular venous pressure
  • Dysponea
89
Q

what are the risk factors of aortic dissection?

A 
Hypertension- most common risk factor
Trauma
Vasculitis 
Cocaine use
Connective tissue disorders- cause Aortic Dissection in younger adults
90
Q

what are the clinical features of aortic dissection?

A
  • Sudden and severe tearing pain in chest radiating to back
  • Hypotension
  • Asymmetrical blood pressure
  • Syncope
  • Aortic regurgitation, coronary ischaemia, cardiac tamponade
  • Peripheral pulses may be absent
91
Q

what are the investigations of aortic dissection?

A
  • ECG/cardiac enzymes - rule out MI
  • Chest x-ray - widening mediastinum
  • CT scanning- definitive imaging
  • echo - TTE/TOE
  • gold standard = CT angiography
92
Q

what are the risk factors for mitral regurgitation?

A 
female
lower BMI
advancing age
renal dysfunction
prior MI
93
Q

what is the clinical presentation of atrial flutter?

A 
Palpitations
Breathlessness
chest pain 
Dizziness
Syncope
fatigue
94
Q

what are the risk factors for atrial fibrillation?

A 
Over 60 
Diabetes, 
Hypertension
coronary artery disease 
previous MI
structural heart disease
95
Q

what are the causes of RBBB?

A

Pulmonary embolism
IHD
Atrial ventricular septal defect

96
Q

what is the treatment for RBBB?

A

Pacemaker
CRT – cardiac resynchronisation therapy
Reduce blood pressure

97
Q

what is the treatment for LBBB?

A

Pacemaker
CRT – cardiac resynchronisation therapy
Reduce blood pressure

98
Q

what are the causes of LBBB?

A

IHD

Aortic valve disease

99
Q

what are the risk factors for abdominal aortic aneurysm?

A
  • Smoking- MAJOR
  • Family history
  • Connective tissue disorders- Marfan’s, Ehlers-Danlos
  • Age
  • Atherosclerosis
  • Male
100
Q

what antibiotics are used for endocarditis?

A

staph = vancomycin
if MRSA add rifampicin

other bacteria = benzylpenicillin and gentamycin

101
Q

what is the clinical presentation of tetralogy of fallot?

A 
central cyanosis
low birthweight and growth
dyspnoea on exertion
delayed puberty
systolic ejection murmur
102
Q

what are the signs of pericardial effusion?

A
  • Muffled heart sounds - effusion obscures apex beat, and heart sounds are soft
  • Kussmaul’s sign – elevated jugular pressure that rises with inspiration
  • Fall in BP of more that 10mmHg on inspiration (result of increased venous return to right side of heart)
  • Bronchial breathing at left base
103
Q

what are the investigations for pericardial effusion?

A
  • Chest x ray shows large globular heart
  • ECG - low voltage QRS complexes with sinus tachycardia
  • Echocardiography is diagnostic - echo-free space around heart
104
Q

what is the management for pericardial effusion?

A
  • Most effusions resolve naturally
  • Underlying cause should be sought and treated
  • If effusion recurs despite treatment of underlying cause, excision of pericardial segment allows fluid to be absorbed
  • Pericardiocentesis - Diagnostic or therapeutic
105
Q

what are the causes of AVRT?

A 
Congenital
Hypokalaemia 
Hypocalcaemia 
Drugs: amiodarone, tricyclic antidepressants
Bradycardia
Acute MI
Diabetes
106
Q

what is the clinical presentation of AVRT?

A

Palpitations
Severe dizziness
Dyspnoea
Syncope

107
Q

what are the investigations for AVRT?

A

ECG - pre excitation

  • short PR interval
  • delta waves (wide QRS complex that begins slurred)
108
Q

what is the treatment for AVRT?

A 
Vagal manoeuvre
     Breath holding 
     Carotid massage
     Valsalva manoeuvre
IV adenosine
Surgery – catheter ablation of pathway
109
Q

what are the investigations for AVNRT?

A

Sometimes ECG QRS complexes will show BBB
P wave not visible or seen immediately before (normal) or after QRS complex due to simultaneous atrial and ventricular activation

110
Q

what is the clinical presentation of coarctation of the aorta?

A
  • right arm hypertension
  • bruits over scapulae and back
  • Murmur
  • headaches and
  • nosebleeds
  • hypertension in upper limbs
  • discrepancy in bp in upper and lower body
111
Q

what are the investigations for coarctation of the aorta?

A

CXR - dilated aorta indented at the site of the coarctation
ECG - left ventricular hypertrophy
CT - can accurately demonstrate coarctation and quantify flow

112
Q

what are the causes of left sided heart failure?

A 
Coronary artery disease
Myocardial infection
Cardiomyopathy
Congenital heart defects
Valvular heart disease
Arrhythmias
113
Q

what are the causes of right sided heart failure?

A 
Right ventricular infarct 
Pulmonary hypertension
Pulmonary embolism 
COPD
Progression of left sided heart failure
Cor Pulmonale
114
Q

what are the causes of systolic heart failure?

A

Ischaemic heart disease
Myocardial infection
Cardiomyopathy

115
Q

what are the causes of diastolic heart failure?

A

aortic stenosis

chronic hypertension

116
Q

ECG changes in which regions indicates a lateral MI?

A

lead I
aVL
V5
V6

117
Q

ECG changes in which regions indicates a septal MI?

A

V1

V2

118
Q

ECG changes in which regions indicates an anterior MI?

A

V3

V4

119
Q

ECG changes in lateral regions are caused by which artery in an MI?

A

lateral = circumflex

120
Q

ECG changes in inferior regions are caused by which artery in an MI?

A

inferior = RCA

121
Q

ECG changes in anterior regions are caused by which artery in an MI?

A

anterior = LAD

122
Q

A blockage in the LAD will cause ECG changes in which regions?

A

anterior - V3, V4

septal - V1, V2

123
Q

A blockage in the RCA will cause ECG changes in which regions?

A

inferior - leads II, III, aVF

124
Q

A blockage in the circumflex artery will cause ECG changes in which regions?

A

lateral - lead I, aVL, V5, V6

125
Q

what pharmacological treatments can be used for mitral stenosis?

A
  • beta blockers - atenolol
  • digoxin
  • diuretics - furosemide
126
Q

what pharmacological treatments can be used for mitral regurgitation?

A

Vasodilation

  • ACEi - ramipril
  • hydralazine - smooth muscle relaxer

HR control

  • B blockers - atenolol
  • CCB
  • digoxin

fluid overload
- loop diuretic - furosemide

AF/atrial flutter
- anticoagulation

127
Q

what is the management for SVT?

A

1st line = valsalva manoeuvre
2nd = carotid sinus massage
3rd = cardioversion with adenosine
4th = DC cardioversion with defibrillator

128
Q

what type of murmur is heard in a ventricular septal defect?

A

pansystolic

129
Q

which microorganism causes rheumatic fever?

A

group A streptococcus - s.pyogenes

130
Q

what is the pathophysiology of hypertrophic cardiomyopathy?

A

thickened septum below aortic valve causes outflow tract obstruction -> causes left ventricular hypertrophy

131
Q

What are the side effects of colchicine?

A

Diarrhoea and nausea

132
Q

where is the mitral valve best auscultated?

A

5th intercostal space midclavicular line

133
Q

where is the tricuspid valve best auscultated?

A

4th/5th intercostal space lower sternal edge

134
Q

where is the pulmonary valve best ausculated?

A

2nd intercostal space

left sternal edge

135
Q

where is the aortic valve best ausculated?

A

2nd intercostal space

right sternal edge

136
Q

what is the presentation of an arterial ulcer?

A

location = distal extremities (tips of toes, lateral malleolus, phalangeal heads)

characteristics

  • punched-out appearance
  • pale/necrotic wound tissue
  • minimally exudative
  • pale, shiny, taut, thin skin
  • absence of hair
137
Q

what is the presentation of a venous ulcer?

A

location = gaiter area, lower calf to medial malleolus

characteristics

  • irregular shape
  • granular appearance
  • exudative
  • haemosiderin staining
  • lipodermatosclerosis / subcutaneous fibrosis
  • hardening of skin
  • firm oedema
138
Q

what is the gold standard investigation for peripheral artery disease?

A

contrast angiography

139
Q

give 7 signs of shock

A 
pale
sweaty
cold
pulse is weak and rapid
reduced urine output
confusion
weakness/collapse
140
Q

what can cause hypovolaemic shock

A

loss of blood

loss of fluid

141
Q

what is class 1 shock?

A 
15% blood loss
pulse <100bpm
BP normal
PP normal
resp rate 14-20
urine output >30ml/hr
142
Q

what is class 2 shock

A 
15-30% blood loss
pulse >100bpm
BP normal
PP decreased
resp rate 20-30
urine output 20-30ml/hr
143
Q

what is class 3 shock

A 
30-40% blood loss
pulse >120bpm
BP decreased
PP decreased
resp rate 30-40
urine output 5-15ml/hr
144
Q

what can cause cardiogenic shock

A

cardiac tamponade
PE
acute MI
fluid overload

145
Q

what is septic shock

A

systemic inflammatory response assoicated with infection

146
Q

what causes hypertrophic cardiomyopathy?

A

inherited

sarcomeric gene mutations

147
Q

what can cause arrhythmogenic cardiomyopathy (ARVC/ALVC)?

A

desmosome gene mutations

148
Q

what is the inheritance pattern for cardiomyopathy?

A

autosomal dominant

149
Q

what is the pathophysiology of hypertrophic cardiomyopathy?

A

systole = normal
diastole is affected
heart is unalbe to relax due to thickening of ventricular walls

150
Q

what is the pathophysiology of dilated cardiomyopathy

A

ventricular dilation and dysfunction - poor contractility

151
Q

what is the pathophysiology of arrhythmogenic cardiomyopathy (ARVC/ALVC)?

A

desmosome mutations lead to being pulled apart and ventricles are replaced with fatty fibrous tissue

152
Q

what is restrictive cardiomyopathy/

A

poor dilation of the heart restricts diastole

153
Q

what is the classification system for PVD

A

fontaine classification

154
Q

what might an ECG look like in hypertrophic cardiomyopathy?

A

large QRS complexes

large inverted T waves

155
Q

what might an ECG look like in arrhythmogenic cardiomyopathy

A

epsilon waves

156
Q

give 2 ECG signs of PE

A

sinus tachycardia

atrial fibrillation

157
Q

what is Wolff-Parkinson-White syndrome?

A

AVRT

158
Q

what does the ECG show in Wolff-Parkinson-White syndrome?

A

short PR interval
wide QRS complex
delta wave

159
Q

what is the treatment for WPW syndrome?

A
  1. vagal manoeuvre
  2. IV adenosine
  3. catheter ablation

Phase 2A revision (38 decks)

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